Colon cancer screening

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Colon cancer screening can detect polyps and early cancers in the large intestine. This type of screening can find problems that can be treated before cancer develops or spreads. Regular screenings may reduce the risk of death and complications caused by colorectal cancer.

Information

SCREENING TESTS

There are several ways to screen for colon cancer.

Stool test:

Polyps in the colon and small cancers can cause small amounts of bleeding that cannot be seen with the naked eye. But blood can often be found in the stool.

This method checks your stool for blood.

The most common test used is the fecal occult blood test (FOBT). Two other tests are called the fecal immunochemical test (FIT) and stool DNA test (sDNA).

This test uses a small flexible scope to view the lower part of your colon. Because the test only looks at the last one third of the large intestine (colon), it may miss some cancers that are higher in the large intestine.

A colonoscopy is similar to a sigmoidoscopy, but the entire colon can be viewed.

Your health care provider will give you the steps for cleansing your bowel. This is called bowel preparation.

During a colonoscopy, you receive medicine to make you relaxed and sleepy.

Sometimes, CT scans are used as an alternative to a regular colonoscopy. This is called a virtual colonoscopy.

Other test:

Capsule endoscopy involves swallowing a small, pill-sized camera that takes a video of the inside of your intestines. The method is being studied, so it is not recommended for standard screening at this time.

SCREENING FOR AVERAGE-RISK PEOPLE

There is not enough evidence to say which screening method is best. But, colonoscopy is most thorough. Talk to your health care provider about which test is right for you.

Both men and women should have a colon cancer screening test starting at age 50. Some providers recommend that African Americans begin screening at age 45.

Screening options for people with an average risk for colon cancer:

Colonoscopy every 10 years

FOBT or FIT every year (colonoscopy is needed if results are positive)

sDNA every 1 or 3 years (colonoscopy is needed if results are positive)

Flexible sigmoidoscopy every 5 to 10 years, usually with stool testing FOBT done every 1 to 3 years

Virtual colonoscopy every 5 years

SCREENING FOR HIGHER-RISK PEOPLE

People with certain risk factors for colon cancer may need earlier (before age 50) or more frequent testing.

More common risk factors are:

A family history of inherited colorectal cancer syndromes, such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colorectal cancer (HNPCC).

A strong family history of colorectal cancer or polyps. This usually means close relatives (parent, sibling, or child) who developed these conditions younger than age 60.

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